Wandering spleen presenting as bleeding gastric varices

Area of Science:

• Gastroenterology
• Radiology
• Surgical Pathology

Background:

• Ectopic spleen (splenoptosis) is a rare congenital anomaly where the spleen resides outside its normal anatomical position in the left upper quadrant.
• Symptoms are highly variable, ranging from asymptomatic presentation to acute abdominal emergencies like splenic infarction or torsion.
• Diagnosis can be challenging due to nonspecific symptoms, necessitating advanced imaging modalities.

Observation:

• A middle-aged woman presented with hemetemesis (vomiting blood) attributed to gastric varices.
• The gastric varices were found to be secondary to chronic volvulus (twisting) of an ectopic spleen.
• Preoperative imaging, including ultrasonography, endoscopy, and computed tomography, was crucial for diagnosis.

Findings:

• The case involved splenic torsion within an ectopic spleen, leading to gastric varices and subsequent hemetemesis.
• Diagnostic imaging successfully identified the ectopic spleen and its torsion.
• Surgical intervention confirmed the diagnosis and provided successful treatment.

Implications:

• This case underscores the importance of considering rare conditions like ectopic spleen in the differential diagnosis of gastrointestinal bleeding and abdominal complaints.
• Advanced imaging techniques are vital for accurate preoperative diagnosis of splenoptosis complications.
• Successful surgical management highlights the potential for effective treatment of this rare condition.